Comprehensive Gender Care at University Hospitals

Creating a unique inclusive program for LGBTQ patients

Innovations in Urology | Winter 2020

Subham Gupta, MD

People in the LGBTQ community often face barriers to healthcare access, but University Hospitals is building a comprehensive gender care program to break down those barriers. Shubham Gupta, MD, FACS, Director of Gender and Sexual Diversity Services and Division Chief of Reconstructive Urology, University Hospitals Urology Institute, joined UH in 2019, and he has been spearheading the development of an inclusive gender care program for the LGBTQ community.

FROM PRIMARY CARE TO GENDER AFFIRMATION

The UH LGBTQ gender care program includes multiple different service lines backed by a network of LGBTQ-friendly physicians. “Operationally, the program is anchored by a central navigator who takes initial calls and is able to route patients to the appropriate provider within the UH network,” says Dr. Gupta. Whether patients are looking for something as simple as primary care provided by a doctor and staff trained to work with the LGBTQ community, or more complex services, UH is striving to offer a complete answer. Patients also can access mental health professionals, social services and advocacy support.

The program also serves the transgender population by offering access to hormone therapy, mental health professionals and gender affirmation surgery.

The overarching goal of the program is to provide basic and specialty services to a population in need. “People who are in a gender or sexual minority have a lot of barriers to care,” says Dr. Gupta. “You should have the best possible care regardless of your sexual orientation or gender identity.”

GENDER AFFIRMATION SURGERY

Under the wide umbrella of the gender care program, Dr. Gupta and Tobias Long, MD, plastic surgeon at University Hospitals Cleveland Medical Center and Clinical Assistant Professor, Case Western Reserve University School of Medicine, perform gender affirmation surgeries for male-to-female and female-to-male transgender individuals. While “top surgery,” either a mastectomy or breast implants, is commonly performed across the country, UH differentiates itself through genital or “bottom” surgery.

Drs. Gupta and Long are performing vaginoplasties and phalloplasties, complex reconstructive surgeries resulting in fully functional female and male genitalia, respectively.

UH LEADERS IN GENDER CARE

In addition to Drs. Gupta and Long, the UH gender care program is supported by a number of other leaders in the healthcare system. Margaret Larkins-Pettigrew, MD, MEd, MPPM, Director and Edgar B. Jackson Jr., MD, Endowed Chair in Clinical Excellence and Diversity, University Hospitals Center for Clinical Excellence and Diversity, and Associate Professor, Department of Reproductive Biology, School of Medicine, serves as the program’s executive champion. Lee Ponsky, MD, Director, UH Urology Institute, Leo and Charlotte Goldberg Chair of Advanced Surgical Therapies, Master Clinician in Urologic Oncology, UH Cleveland Medical Center, and Professor and Chairman, Department of Urology, School of Medicine, helped to attract Dr. Gupta to UH and continues to support the program.

Michelle Caster, MD, Family Medicine, UH Cleveland Medical Center, and Assistant Professor, School of Medicine, is leading primary care services in the program; and Matt Andersen, MD, Psychiatrist, UH Cleveland Medical Center, and Senior Instructor of Psychiatry, School of Medicine, is focused on offering mental health support.

EXPANDING CARE

Over time, the gender care program will continue to grow. Dr. Gupta is working with physicians in London, England, to share ideas and research on phalloplasties, and he is excited about the potential of biomedical engineering to advance transition surgeries.

As UH puts resources into biomedical research for vaginoplasties, it will realize a cross-disciplinary benefit for female cancer patient survivors. “If we are able to…have a functioning vagina for transgender individuals, we can also apply that technology to help women who are survivors of pelvic cancer and have issues with vaginal stenosis or shortening,” says Dr. Gupta.

Providing comprehensive gender care is an ongoing commitment at UH. “I’ve received support from my chair, the administrators in my department and executive leadership to build this program and build this coalition,” says Dr. Gupta. “We are able to leverage UH’s vast clinical network and its legendary research facilities to build a world-class program.”

Patients can reach the program and find the care they need by calling 216-286-LGBT.